It’s not surprising given that a third of Americans are overweight and another third are obese. As physicians, helping people achieve their best health often includes a discussion on food choices and exercise. From a perspective of general well-being, feeling good about one’s self and having energy to engage in the activities a patient wants to, diet and exercise are the most important first step. Most of the medical illnesses that Americans deal with are also much improved (and some cured) with changes in diet and exercise. Weight also affects a person’s risk of at least 13 cancers, including the more common breast and colon cancers.
But what to do? The problem is that most people know this. Most people know, generally, what’s healthy and what’s not, so what’s the problem?
In the next few months, we’ll be putting out a series of blog articles on weight loss. There won’t be detailed calorie counting or required meals. But we’ll cover some of the general ideas people need to learn to sustainably lose weight and keep it off in the long run.
Recognize it’s important
Accepting that this issue is important is critical. It’s essential for feeling more energetic, for feeling healthier, and most importantly for brain space. Think about it, how much of your daily thinking is about your food, your weight and your activity levels? Or about problems you deal with that you know would be so much better if only you were xx lb lighter?
Just as a final exam is important or planning a birthday party or working towards a promotion or deciding to buy a new home, losing weight may be the most important life change you need to make right now. Putting it in context as to how you deal with other life decisions helps to understand what it’s going to take from you to change your thinking and action around food. If you can change your thinking about food, the weight will come off. But this is going to take some work.
Recognize that the problem is not you, it’s the system
If your child came home with a C in math class, you recognize that your child needs some help, you talk with them about study habits, make sure they’re doing their homework, maybe get them a tutor. If you find out that 1/3 of the class got a C and 1/3 a D, then you call the school to complain about a teacher.
If a staff member comes in an hour late one day, she need to explain herself. If every staff member comes in an hour late, our first thought goes to “what’s going on out there”. It’s probably traffic or a construction or something else. And usually all our patients and even physicians are late too!
The culture around talking about weight issues in America focuses on personal failings. People need to just stop eating so much. People need to just stop being so lazy. People need to just stop the fast food. As you start your journey, you need to recognize that while it’s true that diet is the key to weight loss, the system is designed to make you fail. Two-thirds of Americans are overweight or obese. How can that be solely due to “personal failings”?
If you realize you are working against the system to get to your goal, you’ll be more realistic about how hard this is going to be. You’ll also realize that you can’t expect help from most places. “Healthy” restaurants, “healthy” snacks, “good, supportive” friends, even many popular diets and nutritionists may not be able to help you. You really have to accept that this change has to come from within, from how you think about food so that you are a thoughtful, mindful eater at all times, even when every part of our culture and system around food seem designed to make you gain weight.
Make a commitment, a real commitment
Nearly everyone who’s tried to lose weight before knows that it’s hard. People can be top of their class, get promotions at work, be a most beloved family member that always shows up for others, and always accomplish what they put their mind to, until they try to lose weight.
Anyone who’s taken a major test understands you need to make sacrifices in the time leading up to the exam. Maybe skipping out on social events, dedicating evenings to study or avoiding certain stressful situations so they don’t throw you off track. Anyone who’s planned a big event, knows there’s a LOT of time dedicated in the months and especially weeks leading up to the big night. It’s called “preparing”.
If you want to make a lasting change in your life, working against the way you’ve eaten for the last few years and often last few decades, working against a food culture that wants you to just eat more, and to achieve something you’ve likely tried and failed at before, you need to make a commitment.
Honestly, for at least the first 2-3 months, you have to be prepared to give 1-2 hours a day to this project. You have to read about what is going on in your body, what are the different types of diets out there that you might find sustainable, what kinds of foods are better or worse for you, and you’re going to have to learn how to grocery shop and cook.
On a daily basis, at the beginning, you’re going to have to make sure you have support. If you can afford a weight loss coach, great. But for the rest of us, listening to a daily podcast can be life-changing. It’s 20-90 min a day of listening to motivating, helpful information on why this is important, confirming it’s hard, and pushing you to stick with it. After a while you’ll notice, the days you skip a podcast, you tend to eat less healthy. Having ongoing, daily support is a big deal.
This also means, at least at the beginning, that you need to avoid situations you just know will derail you. If you had an exam coming up and your friends were going out a few nights before and you just KNOW you’ll be out late with them and throw off your study schedule, most people would take a rain check. As you start your journey to lasting weight loss, if you’ve got a choice to join friends or attend an event where you just KNOW you’re going to throw off your healthier eating choices, just don’t go.
And like exams, events and house hunting, the sacrifices aren’t forever. You work hard to get a finite goal, then you go back to your routine. So, when 1-2 hours of thinking of, learning about and listening to food and diet information gets tedious, remember, it’s not forever. It’s just for the first 2-3 months. And after that, if you’ve successfully changed your thinking, you’ll no longer need so much time every day. You’re eating will be better, the weight will continue to come off. Of course, you’ll still need support, podcasts, good friends and company will be a big part of staying healthy, but it’ll come a lot more naturally.
There are many books to read about your body’s physiology and to help you understand why this is so hard. The first book I recommend everyone read is The Obesity Code. But here’s a longer list if you want more:
- The Obesity Code by Jason Fung, MD
- The South Asian Health Solution by Ronesh Sinha, MD
- The Complete Guide to Fasting by Jason Fung, MD
- Good Calories, Bad Calories by Gary Taubes
- The Big Fat Surprise by Nina Tiechholz
- The Telomere Effect by Elizabeth Blackburn, PhD and Elissa Epel, PhD
There are also a lot of weight loss podcasts out there. Not every podcast is for every person. But it’s important to find one (or five!) that you enjoy listening too and that you find enjoyable. Here are a few to consider:
- Weight Loss for Busy Physicians
- The Life Coach School
- Losing 100 lbs with Phit-N-Phat
- The Obesity Code Podcast
- The Low Carb Cardiologist Podcast
- 2 Keto Dudes
Learning about Food:
There is no magic pill to get you to a BMI of 22 in 2 weeks. But there is a very real, effective way to start to lose weight that makes you happier, feel more in control of your life and improve your sense of well-being. Most importantly, if you can change your eating habits by changing your thinking—not just sheer willpower—you can keep it off for good.
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